D.C. Report: HIT Committee Settles on Vocabulary Recommendations, Efforts to Expand Capital Loan Programs to Rural Hospitals

HIT Standards Committee Settles on Recommendations for Vocabulary, Reviews ‘Summer Camp’ Work ONC’s Health IT Standards Committee (HITSC) met for the last time this summer on Wednesday. During the day-long affair, members transmitted recommendations on an array of areas, including clinical quality and vocabulary standards, patient matching and Stage 2 certification. Of particular note is that HITSC endorsed a single set of vocabulary standards (.pdf) and a single guide for putting them in place for each domain of quality reporting measures. HITSC adopted Systematized Nomenclature of Medicine-Clinical Terms (SNOMED-CT) as the standard medical vocabulary for use in electronic health records for sharing information across specialties and sites of care. For lab and clinical identifiers, HITSC will recommend Logical Observation Identifiers Names and Codes (LOINC) is used. And as a standard for the names for clinical drugs and drug delivery devices, RxNorm will be recommended for Stage 2. Despite these recommendations, committee members acknowledged that further work will have to be undertaken as issues are sure to arise.

Patient Matching Power Team Also discussed Wednesday were recommendations put forth by HITSC’s Patient Matching Power Team—one of a handful of ad hoc groups formed over the summer as part of HITSC’s “Summer Camp.” The Power Team made recommendations (.pdf) and raised issues pertaining to patient attributes that could be used for matching (in order to understand the standards that are needed), data quality, formats for these data elements, and what data are returned from a match request. However, the Power Team acknowledged the limits of its offerings, saying “We found little data and no standards to support recommendations regarding evaluating and making match quality visible. We are forced to conclude…that there is insufficient information at this time to provide specific recommendations.” Instead they focused on what data should be returned during a query and less on how to increase matching rates. “Responses to patient queries should not return any patient attributes that were not included in the original query, though it may be appropriate for the response to indicate other data that could be useful in matching this patient.” They concluded that ONC or other appropriate agencies should sponsor specific research and analysis to identify the most relevant and achievable metrics to return in response to a patient matching query.

Implementation Workgroup Recommendations Significantly informed by a letter co-signed by CHIME, AHA, HIMSS and other HIT stakeholders, the HITSC Implementation Workgroup submitted recommendations for improving the certification, attestation, and reporting process for Meaningful Use Stage 2 Wednesday. Among some of their recommendations were to “Clarify and simplify requirements for possession and attestation to use of certified EHR technology,” “Publish the HHS process for conducting MU and Certification compliance audits,” and “Build realistic software development and implementation timelines into regulatory requirements.” For more information, see the Implementation Workgroup PowerPoint presentation.

HHS, USDA Join in Effort to Expand Capital Loan Programs to Rural Hospitals and Clinicians In an announcement made this week, President Barack Obama vowed to increase rural access to healthcare workers and technology. The President announced five new initiatives, following recommendations made by the White House Rural Council, involving divisions of the U.S. Department of Agriculture (USDA), the U.S. Department of Health and Human Services (HHS) and the Small Business Administration (SBA). Two of the five related directly to increasing physician recruitment at Critical Access Hospitals (CAHs) and expanding health information technology in rural America. According to an administration factsheet, the USDA and HHS will sign an agreement linking rural hospitals and clinicians to existing capital loan programs that enable them to purchase software and hardware needed to implement health information technology (HIT). Additionally, HHS will issue guidance to expand eligibility for the National Health Service Corps loan repayment program so that Critical Access Hospitals can use these loans to recruit new physicians.